Long-Term Effects Of Early Stress On Depression Symptoms In Adulthood

Objective: Prenatal exposure to earthquake stress may have an effect on fetal neural development,and this effect may persist until adolescence or adulthood,even the lifetime.When the infancy exposure to earthquake stress,a coordinated physiological response involving autonomic,neuroendocrine and immune system components are activated,which may has long-term efficacy.Thus,the purpose of this study was to investigate the persistent effects of prenatal and postnatal stress on depression symptoms in adulthood.Methods: The subjects of this cross-sectional study were recruited from workers of Kailuan Mining Group.Nine mining areas and five other institutes were investigated for total 1534 people.They were divided into three groups according to the different period of earthquake exposure: infancy exposure(372),fetal exposure(406)and control group(550).The group with fetal exposure was further divided into 1-3months,4-6months and 7-9 months subgroups based on the exposure period of pregnancy.One to one interview was used to investigate the baseline date and the situation of the respondents and their mothers during the earthquake.The baseline date mainly includes some social demographic data: name,age,date of birth,sex,education,occupant,income,smoking and drinking history and so on.The situation of the respondents and their mothers during the earthquake date mainly includes:whether the earthquake caused houses collapsed,whether the earthquake caused their mothers buried,whether the earthquake caused their fathers injured,whether the earthquake caused other relatives injured.All date were entered into the computer while dual check and entry in form epidata3.0database,and a standard cross check of the data was carried out to ensure the accuracy and reliability of the data.The software of SPSS21.0 was used to perform statistical analysis.All measurement data over the three groups werecompared using one-way analysis of variance or Kruskal-Wallis test.Fisher’s Least Significant Difference(LSD)procedure was used to conduct pairwise comparison.For the dichotomous and categorical variables,Pearson’s chi-squared test was performed across groups.Finally,we conducted logistic regression analysis to determine the significant predictors for the incidence of depression symptoms.Result:The total number of all subjects is 1534 with 128 subjects did not agree to accept the interview.Of the 1406 subjects,78 were excluded from the final analysis with 25 participants’ general information is incomplete,29 had other traumatic events in addition to earthquake during his/her mother pregnancy,3participants with thyroid gland dysfunction,14 participants lack of HAMD score,7 participants lack of SCID data.1328 meets the final evaluate criteria,include 1146 males and 182 females.1 No significant difference were found in gender,nationality,marital status,education,occupation,income,drinking history and smoking history across the three cohorts(P>0.05),except for the average age(P<0.001).2 Most of the situation of the respondents and their mothers during the earthquake did not differ across the three cohorts(P > 0.05),except for whether the earthquake caused mother buried(P < 0.001).There are significant differences in the rate of depression symptoms(P=0.002),but not in the rate of MDD.3 The fetal exposure cohort was further categorized into three subgroups with 1-3 months,4-6months,7-9months subgroups based on the exposure period of pregnancy.No significant differences on the MDD or depression symptoms were seen across three cohorts,although the number of subject with MDD or depression symptoms for 7-9 months subgroup was slightly more than that for the other two subgroups(P>0.05).4 The fetal exposure cohort was categorized into two subgroups on the basis of whether exposure to stressful events during pregnancy,and screened the proportion of depression symptoms respectively.Significant differenceswere found in whether the earthquake caused their mothers buried(P=0.009)and whether the earthquake caused their fathers injured(P=0.002).5 The infancy exposure cohort was categorized into two subgroups based on whether exposure to stressful events during pregnancy,and screened the proportion of depression symptoms respectively.No significant difference were found in situations of the respondents’ mothers during the earthquake(P>0.05).6 First,simple logistic regression analysis was performed for each of the traditional predictors of depression symptoms,with incidence of depression symptoms as the dependent variable and each predictor as the independent variable.Then,we included all the significant factors in to the multiple logistic regression model and used backward selection method to determine the best model for the prediction of depression symptoms.The results of multiple logistic regression analysis show that male is a protective factor for depression symptoms in adulthood;stress from the earthquake(OR=2.539,95%CI(1.413,4.564))and mother spouse casualties(OR=1.904,95%CI(1.006,3.604))are significant predictors on the incidence of depression symptoms,besides the traditional predictors(scores of CTQ,LES).Conclusions:1 Fetal or infancy exposure to earthquake has a long-term effect on depression symptoms in individual adulthood.2 Mothers who are buried during pregnancy or spouse casualties during the earthquake will led to an increase in the risk of depression symptoms in their offspring.3 Male is a protective factor for depression symptoms in adulthood.Stress from the earthquake,father casualties,scores of CTQ and LES are significant predictors on the incidence of depression symptoms.